Ouarian tumors of low malignant potential(OTLMP) or borderline tumors account for approximately 10% of all ovarian neaplasms. Borderline tumors have some but not all of the histologic characteristics af ma lignancy : stratification of epitheliial cells, with some degree of nuclear atypia a,nd inereased mitotic actitity but. without stromal invasion. We reviwed 20 published Rnglish written articlea from 1978 to 1992 and Korean gynecologic cancer regestry of 1990. In this review, we tried to concentrate on several debating is sues in OTLMP: 1) What kind of surgery is needed for each stages?, 2) Is postoperative adjuvant t.herapy needed?, 3) Jf needed, which type? Following result were obtained from the besis of 1516 patients with OTLMP. Patients withh OTLMIP are younger than those with invasive ovarian cancers', mean age was in their forties. The majority of patients(74.5%) had stage I disease, and the incidence dropped ahruptly to 9.4% for stage ll, 15.7% for stage III and 0.4% for stage IV. The most cammon histologic subtype was serous(56.7%), followed by muci noua(38.1%), However, interestingly in Korea and Japan, the mucinous type was the most common one. The primary treatment for OTLMP was surgery, and the conservative surgery to preserve fertility in young women was sufficient for stage I disease with careful follow-up. The majority of patients(79.1%) with stage I disease were treated by surgery alone. Adjuvant such as chemotherapy (CT) and/or radiotherapy(RT) could prolong the recurrence of disease a little later, but failed to increase diaease-free survival significantly in stage I disease. In stageII disease, the surgery should be a total abdominal hysterectomy and bilateral salpingo-oophorectomy with multiple sampling of the peritoneal cavity. About a third of patients with stageII disease received no adjuvant therapy and the others received CT and/or RT, however, there was no difference in outcome of recurrence and survival. In advanced stage. 15% of patients received no adjuvant therapy after initial debulking surgery, and the rest of patients received CT and/or RT. No differences in recurrence and survival between each groups were noticed , too. The status of second-look laparotomy(SLL) did not depend on the stage of the disease. Positive rate of SLL for stage I diaease was not statistically different from that for the combined stages II-IV. Survival for stage I at 5 years was reported to range from 80 to 100%, and even stage III had survival ranging from 64 to 96%. Long-term survival at 15~20 years was also good. Although it is quite difficult to make conclusions because of the lack of prospective randomized studies from this review, it appears clear that surgical removal of the tumor and careful follow-up of patients are all that are necessary in stage I disease and further multi-center prospective study for the effect of adjuvant therapy in advanced disease is definitely needed.
Drug Therapy ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hysterectomy ; Incidence ; Japan ; Korea ; Mucins ; Peritoneal Cavity ; Prospective Studies ; Recurrence

Tricholroacetic acid (TCA) chemical peeling is an effective, versatle and safe therapeutic method for patients with pigmentary disorders, acne scars and aging skin. With an experienced and skilled operator, the associated complications are rare and tend to be mild. No. ystemic toxicity is known to be induced by TCA. We observed the effect of TCA chemical peeling, evaluated by 242 patients themselves with melasma, freckles, senile lentgines, pigmented nevi, seborrheic keratosis, skin tags or acne scars. The patients evaluated TCA peeling as excellent for the treatment of seboirheic keratosis, pigmented nevi, skin tags and acne scars, and as selectively recommendable for the treatment of melasma, freckles and senile lentigines.
Acne Vulgaris ; Aging ; Cicatrix ; Humans ; Keratosis ; Keratosis, Seborrheic ; Lentigo ; Melanosis ; Nevus, Pigmented ; Skin

Objective: The purpose of the present study was to screen the prevalence of aneurysms in migraineurs; to differentiate presenting features in migraineurs with and without aneurysm; and also to correlate the locations of aneurysm to the clinical features of migraine. Methods: A total of 4,416 subjects were interviewed and completed self-reported questionnaires on headache. Of these, 1,773 subjects diagnosed to have migraines based on the International Classification of Headache Disorders II (ICHD-II) criteria were screened for aneurysm by magnetic resonance angiography (MRA). When aneurysm was suspected, further investigation with trans femoral cerebral angiography (TFCA) or three dimensional computerized tomography (CT) angiography was performed. Based upon MRA findings, subjects were grouped into unruptured aneurysm migraine patients (UAMP) and no aneurysm migraine patients (NAMP). Results: The prevalence of aneurysm was 3.6% (63 of 1,773) with the mean age of 56.0 years, which were not different from those of general population. There was no difference in migraine subtypes between UAMP and NAMP. Aggravation of headache by estrogen replacement therapy during menopause (p=.039), history of migraine in young age (p= .021), diplopia (p=.026), and retroauricular pain (p=.025) were significantly associated with presence of aneurysm. Although aneurysms were detected more in anterior circulation, there was no correlation between aneurysm site and headache location. The average size of aneurysm was 3.5 ± 2.1 mm and none were ruptured. Interventional therapy of aneurysm did not alter the feature of migraine. Conclusions: The incidence of aneurysm was not different in migraine patients as compared to the general population. Some features which significantly differentiate whether migrainuers have aneurysm or not warrant further study to have a predictive and localizing value.

The purpose of this study was to compare the status of sanitation education and sanitation knowledge in school foodservice with commercial foodservice. The survey sample was institutional foodservice directors (n = 88) in A office of education and commercial foodservice directors (n = 81) in B foodservice industry. The questionnaire requested information about demographic information, situation of sanitation education, contents of sanitation education practice, importance of sanitation education, and sanitation knowledge. Data were analyzed using frequencies, means, chi-square test, and t-test. Over half (52.1%) of the respondents were institutional foodservice directors, 47.9% of the respondents were commercial foodservice directors. The majority of institutional foodservice directors were 25-29 years of age (38.6%), over 10 years of working experience (63.6%) and commercial foodservice directors were 25-29 years of age (53.1%), 5-10 years of working experience (35.0%). 66.3% of the respondents were educated food safety once a month, but 8.6% of commercial foodservices were never educated. The majority of the respondents used printing materials (73.3%) or lecture (74.8%). The importance level of institutional foodservice directors about sanitation education was significantly higher than commercial foodservice directors. The average score of institutional foodservice directors'sanitation knowledge was 87.05/100.00. The commercial foodservice directors'sanitation knowledge 67.74 was significantly lower than institutional foodservice directors (p< 0.05). Therefore, there should be a systematic education program designed for commercial foodservice directors.
Surveys and Questionnaires ; Food Safety ; Humans ; Sanitation

No abstract available.
Alleles* ; Base Sequence* ; Clone Cells* ; Cloning, Organism* ; HLA-DR Antigens

No abstract available.
Heart Valve Prosthesis* ; Heart Valves*

In the treatment of malleolar fracture, anatomical reduction and rigid internal fixation are essential to prevent the complications such as infection, malunion or nonunion, traumatic arthritis, skin necrosis and joint contracture. But it is often difficult to obtain rigid fixation for medial malleolar fracture because of its comminution or thin cortex with osteoporosis. Generally, two operative methods are available for medial malleolar fracture, which are malleolar lag screw fixation and tension band wiring. The purpose of this paper is to analyze which operative method is better for anatomical reduction and rigid fixation and has less postoperative complications for medial malleolar fractures. From March 1992 through March 1995, 88 patients had undergone surgical intervention for medial malleolar fractures. The patients were divided into 2 groups according to operative method for medial malleolar fracture. For one group, malleolar lag screw together with or without a K-wire was used in 48 patients, and for the other group, tension band wiring was used in 40 patients. The average follow-up periods were 14 months in screw fixation group and 13 months in tension band wiring group. The average union time were 15.4 weeks (8-17 weeks) in screw fixation group and 12.2 weeks (6-15 weeks) in tension band wiring group. 27 cases (56%) showed excellent result in screw fixation group and 30 cases (75%) in tension band wiring group. In the patient over 50 years old, 2 (15%) in 13 cases showed excellent result of screw fixation group, while 5 (45%) in 11 cases of tension band wiring group. We concluded that tension band wiring is a better method for medial malleolar fracture to obtain early union and to prevent postoperative complications, especially in the elderly patient.
Aged ; Arthritis ; Contracture ; Follow-Up Studies ; Humans ; Joints ; Middle Aged ; Necrosis ; Osteoporosis ; Postoperative Complications ; Skin

BACKGROUND AND OBJECTIVES The etiology and pathophysiology of acute peripheral vestibulopathy are largely unknown. The purpose of this study is to evaluate the manifestation of the autoantibodies and complements in patients with acute peripheral vestibulopathy. MATERIALS AND METHODS We checked anti-ds-DNA, rheumatoid factor, anti phospholipid IgG and IgM, anti nuclear antibody (ANA), C3, C4 in 72 patients who were diagnosed as acute peripheral vestibulopathy on physical examination and the caloric test. The results of the patients with unilateral acute peripheral vestibulopathy were compared to those of the patients with bilateral acute peripheral vestibulopathy. RESULTS Twelve patients (16.6%) in anti-ds-DNA, 4 patients (5.5%) in C3, 10 patients (13.8%) in C4, 2 patients (2.7%) in anti-phospholipid IgG and 13 patients (18%) in antinuclear antibody (ANA) showed abnormal findings among patients with acute peripheral vestibulpahty. There was no difference in the manifestation of the autoantibodies and complements between the patients with unilateral and bilateral acute peripheral vestibulopathy. CONCLUSION The autoimmune diseases may be one of etiologic factors in acute peripheral vestibulopathy.
Antibodies, Antinuclear ; Autoantibodies ; Autoimmune Diseases ; Caloric Tests ; Complement System Proteins ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Physical Examination ; Rheumatoid Factor ; Vestibular Neuronitis

No abstract available.
Lymphangioma, Cystic* ; Turner Syndrome* ; Ultrasonography*

Mucocele of the appendix is uncomrnon and rarely diagnosed preoperatively. The malignant rountpart-i.e. mucinous cystadenocarcinoma--has the same grross appearance and many micro scopic features in cornmon wilhe the benign form. It rnay be associated with ovarian mucinous cystadenoma of strikingly similar microscopic appearence. A serious complication is a rupture of the mucoeele resulting in pseudomyxoma peritonei. Each case of benign and malignant mucocelr of the appendix falsely diagnosecl as an oovarian tumor before laparotxumy are presented wilh a brief rieview of the literatures.
Appendix* ; Cystadenoma, Mucinous ; Mucins ; Mucocele* ; Pseudomyxoma Peritonei ; Rupture